How would you manage a recurrent meningioma of the cervical spine after resection alone?

What would your dose and volumes be if there is residual or recurrent tumor not amenable to re-resection? When would you favor SRT over conventional fractionation, and why? Would difference in grade (1 vs 2) change your recommendations?

Answer from: Radiation Oncologist at Community Practice

I had a case like this 2 years ago. Treating with 5 fractions felt so "en vogue" and I therefore phoned some CNS-focused friends who may be considered spine SBRT leaders, and they all recommended standard fractionation, supporting my inclination.My case was a subtotally resected Gr 1 tumor with blan...

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Radiation Oncologist at Renaissance Institute of Precision Oncology & Radiosurgery
I would have endorsed your 5 fx plan. 18-21 Gy/3 f...

Answer from: at Academic Institution

Just to add, could consider Avastin, or eve/oct, or Lutathera if no additional neurosurgical or radiation options. Though of course, meningiomas are not very chemosensitive, these are reasonable regimens.

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How would you manage a recurrent meningioma of the cervical spine after resection alone?

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